Why Portland refuses to fluoridate its drinking water

For the fourth time since 1956, Oregon's biggest city just refused to add the anti-cavity compound to its famously clean tap water

Protestors hold signs in Portland's City Hall during a 2012 vote to add fluoride to the city water.
(Image credit: AP Photo/Don Ryan)

For people used to thinking of Portland as the earnestly quirky liberal oasis portrayed in Portlandia and the style pages of The New York Times, the idea that Oregon's largest city agrees with the conspiracy-minded John Birch Society about dosing citizens with fluoride may seem odd. But on Tuesday, for the fourth time since 1956, Portland voters rejected a plan to fluoridate the city's drinking water. As Slate's Jake Blumgart asks, "What's the matter with Portland?"

The vote wasn't even close: The anti-fluoride side won 60 percent to 40 percent. This despite the pro-fluoride side out-raising opponents $850,000 to $270,000 (including cash and in-kind donations). "There's a libertarian component to Oregon politics," Oregon State University political scientist Bill Lunch tells The Oregonian, "a kind of opposition to what the establishment might want."

Portland has a long history with resisting fluoride, explains Ryan Kost in The Oregonian:

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In the 1950s, residents considered the question of fluoridation about the same time many of the nation's other large metro areas were adopting the practice as a way of fighting tooth decay. Portland voters bucked the trend and rejected the proposal. They said no again in 1962. It seemed Portlanders had come around to the idea in 1978 when they approved a fluoridation plan. But two years later, they reversed course and voted to scrap it. Since then, fluoridation has remained a constant political issue, on par with mandatory gas station attendants. [Oregonian]

In September, the Portland City Council quickly voted to finally add fluoride to the city's water, starting in March 2014. "The revolt was instantaneous," says Aaron Mesh at Willamette Week. Opponents gathered more than 33,000 signatures to put the measure on the ballot, and here we are. Half of the anti-fluoride money came from out of state, "including Tea Party supporters in Kansas and Utah, and a controversial alternative physician outside Chicago," but the "no" vote seems to be "rooted in Portland's organic ethos."

The names of the groups involved in the fluoride battle gives a pretty good sense of each side's argument: Healthy Kids, Healthy Portland on the pro side, Clean Water Portland heading up the opposition. The opponents were angry that the City Council approved the measure with a vote, but the biggest factor in their favor "was simply the the high quality and treasured reputation of the city's Bull Run water supply," says Jeff Mapes at The Oregonian.

Portland's water has always indeed been sold as largely untreated and literally fresh from the Bull Run watershed, which is protected from logging. So when opponents dubbed themselves "Clean Water Portland" and complained of putting chemicals in the water, they had a more receptive audience than they would in cities where most people would just as soon skip drinking water from the tap. [Oregonian]

What did the fluoride proponents have? For starters, "the endorsement of the massed forces of rationality and medical authority," says Slate's Blumgart. But like the pro-fluoride campaigners before them, they underestimated the passion and organization of their opponents. They thought science and the well-documented benefits to dental health would be enough. In short, says Blumgart, they "brought policy papers to a gun fight."

While there are surely conspiracy theorists and anti-government militants among the ranks of today's Clean Water Portland, the organization's spokespeople and supporters generally do not express the conservative rhetoric (such as invoking "socialized medicine") that defines fluoride opposition elsewhere. Such tactics would never work in this liberal city. Instead, opponents rely on attachment to the environment and natural health care, as well as the current mistrust of pretty much all institutions....

Clean Water Portland insists that emerging science supports its claims, but most of them consist of data cherry-picked from limited research and studies that actually conclude in favor of fluoridation. Politically, that hasn't really mattered. It's easy to sow fear about chemicals being dumped in a pure, natural resource. [Slate]

There are lots of Portland-specific elements to this fight, says Joel Millman in The Wall Street Journal. For example, several brewers argued against polluting their craft beer with fluoride, and "even some of the city's famed indie-rock musicians are taking sides."

The Dandy Warhols joined what their singer [Zia McCabe] called the Public Water/Public Vote music festival soon after the city council's 2012 decision to fluoridate, drawing bands with names like Guantanamo Baywatch and the Sexy Water Spiders, and creating enough buzz to gather the 20,000 signatures required to put fluoride on the ballot....

Pro-fluoriders have their own rock-band supporters. Among them, apparently, is Colin Meloy, member of Portland's revered alternative band, The Decemberists. "How can you hate on the GOP for being creationist science deniers and then go on about how vaccines and fluoridation are poison," reads a January post on his Twitter account, which is linked from the website colinmeloy.com. In April, the account tweeted disdain for the anti-fluoride documentary, "An Inconvenient Tooth." [Wall Street Journal]

But the Rose City is hardly alone, says Sarah Kliff at The Washington Post: "Forty-four cities around the world — largely in the United States, Australia, and Canada — have passed anti-fluoridation policies this year." Portland will stay the largest fluoride-free city in the U.S. for now, but in this long-running "fluoridation war," and the anti-fluoride side is losing, says Kliff.

Americans living in areas with fluoridated water increased from 62 percent in 1992 to 69 percent in 2006, the most recent year for which data is available. The American Dental Association now estimates that 72.5 percent of Americans live in areas with fluoridated drinking water. [Washington Post]

The 900,000 people served by the Bull Run reservoir won't be among those fluoridated Americans, for now. But both sides expect Portland's long-running fluoride war to flare up again.

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Peter Weber, The Week US

Peter has worked as a news and culture writer and editor at The Week since the site's launch in 2008. He covers politics, world affairs, religion and cultural currents. His journalism career began as a copy editor at a financial newswire and has included editorial positions at The New York Times Magazine, Facts on File, and Oregon State University.